Zepbound and alcohol: can you drink on Zepbound?

When you start taking Zepbound (tirzepatide), there are a lot of recommendations that get thrown your way — from changing what you eat to how you eat and more. But what about what you drink? Can you drink alcohol on Zepbound?

The short answer is: it depends. Even though Zepbound is not known to interact with alcohol, there are some reasons you may want to avoid (or at least limit) how much you drink on Zepbound. Read on as we explore what might happen if you mix Zepbound and alcohol, and offer guidance for safer drinking while you’re on Zepbound. 

Zepbound is not known to interact with alcohol directly, so technically, yes, you can drink alcohol on Zepbound. That yes is italicized because it comes with several caveats:

• Alcohol can lower your inhibitions and lead you to consume more calories, making it harder to lose weight on Zepbound.

• People experience poorer sleep quality and increased snoring after drinking alcohol, which can lead to weight gain and contribute to obstructive sleep apnea (OSA).

• Drinking alcohol causes side effects like nausea, dehydration, and acid reflux that may worsen the side effects you’re already experiencing on Zepbound. 

• Heavy drinking can increase the risk of serious side effects that can also occur on Zepbound, such as hypoglycemia (low blood sugar), pancreatitis, and kidney problems.

• Even if alcohol is safe for some people to drink on Zepbound, it may not be safe for you, depending on other medications you’re taking or other health conditions you may have. 

Bottom line: An occasional drink could be safe on Zepbound, especially if you’re otherwise totally healthy and your healthcare provider says it’s okay. But alcohol may worsen how you feel on Zepbound or directly impede your treatment goals, whether you’re taking Zepbound for weight loss or OSA. To know whether you can drink alcohol on Zepbound, your best bet is to consult your healthcare provider.

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While drinking may be okay for some people on Zepbound, for others, it can cause several effects that simply may not be worth it, such as gastrointestinal distress and more serious side effects like pancreatitis.

Slower weight loss progress

Drinking alcohol may slow your weight loss progress on Zepbound, in part because alcohol is a risk factor for obesity. When people drink, they’re more likely to eat. Studies show that people feel hungrier immediately after drinking alcohol, with increased cravings for heavy, starchy, calorie-dense foods (now we know why pizza and fries sound so delicious after a night out drinking). Alcohol also lowers your inhibitions, which can make it harder to stick to your diet on Zepbound — and that much easier to overindulge on the foods that aren’t so healthy for you.

Some people also eat more simply for the social aspect. Drinking can be a social activity that includes increased food consumption in addition to alcohol. Alcohol also slows fat-burning, so your body may retain more fat from the foods that you eat. Altogether, these impacts can interfere with your progress and make it harder to reach your weight loss goals. 

Worsened side effects 

One way that Zepbound works is by slowing down your digestion. This keeps food in your stomach longer, which helps you feel fuller, eat less, and hopefully lose weight. But it can also give rise to many of Zepbound’s gastrointestinal side effects like nausea, indigestion, and heartburn. These same effects can also be caused by alcohol, since alcohol has similar effects on your GI tract — especially beverages with higher concentrations of alcohol (15% or higher).

Studies show that the more frequently you drink, the more likely you are to suffer from gastroesophageal reflux disease (GERD), a common symptom of Zepbound that affects up to 5% of people taking the weight loss medication.

Many of the foods people turn to while drinking — fatty, starchy, junky foods — are the same foods advised against while taking Zepbound. That’s because these foods also worsen many of Zepbound’s side effects — specifically, nausea, vomiting, diarrhea, and constipation — which affect anywhere from 40% to 85% of people on Zepbound. 

Alcohol is also a diuretic, which means it makes you urinate more and increases your risk of dehydration. This is especially important for people taking GLP-1 medications like Zepbound, since dehydration can worsen common side effects such as nausea, vomiting, constipation, and diarrhea. It may also increase the risk of more serious complications, including kidney problems.

Poorer sleep

Even though it makes you drowsy, alcohol can disturb the quality of your sleep. When you sleep after drinking, you tend to snore more and experience less restful sleep. Chronic poor sleep, in turn, is linked to higher body weights and increased levels of cortisol, the so-called “stress hormone.” 

When your cortisol is high, your body tends to hold on to fat more stubbornly. You are also more likely to overeat, especially foods high in calories, fat, or sugar (are you sensing a theme yet?). And to top it off, poor sleep can make you less motivated to work out. Together, these effects can make it tougher to lose weight on Zepbound. 

Worsened sleep apnea 

Speaking of poor sleep, alcohol can worsen sleep apnea — which can be something to keep in mind if you’re taking Zepbound to treat your OSA. After drinking alcohol, research shows that people can experience:

• More severe snoring

• An increase in the amount of apnea (stopped breathing) and hypopnea (shallow breathing) events per hour, a key measure of OSA

• Altered sleep architecture (sleep stages)

• Lower oxygen saturation (low blood oxygen levels)

Alcohol has such an effect on your breathing during sleep that it’s considered an independent risk factor for sleep apnea, and some studies suggest women might be more at risk for alcohol-induced sleep apnea.

Increased risk of serious side effects

Mixing alcohol with Zepbound may increase your risk of serious side effects such as acute pancreatitis or acute kidney injury. While these complications are rare, they are known potential side effects of Zepbound.

Alcohol is a well-established risk factor for pancreatitis, contributing to 40–70% of chronic cases and playing a role in many acute episodes. Combining alcohol with Zepbound may further elevate this risk.

Alcohol can also worsen dehydration, especially when paired with Zepbound-related side effects like nausea, vomiting, or diarrhea—potentially increasing the risk of kidney injury.

Increased risk of low blood sugar

Hypoglycemia (low blood sugar) is another potentially serious side effect of taking Zepbound, especially for those who also have diabetes. Research suggests that this can happen when  drinking alcohol on an empty stomach. Unfortunately, hypoglycemia  can still happen when drinking alcohol alongside food that contains glucose (such as carbohydrates).

If you have diabetes, your healthcare provider may recommend limiting your alcohol consumption while taking Zepbound—in part due to the elevated risk of experiencing hypoglycemia on tirzepatide. Combining alcohol with insulin or other types of diabetes medicine can also raise your risk of low blood sugar. And, heavy drinking can also lower insulin sensitivity and make it harder to control your blood glucose levels. 

If you don’t currently have diabetes but you have prediabetes, it’s worth noting that heavy alcohol consumption can also increase the risk of developing type 2 diabetes, which may be another reason to avoid drinking on Zepbound. 

Yes, some people may be at greater risk of side effects when mixing alcohol and Zepbound. This includes people with:

• Diabetes, since both alcohol and Zepbound can raise the risk of experiencing low blood sugar. (If you take medications to manage your diabetes, you are at an even greater risk of low blood sugar.)

• Pancreatitis, since both alcohol and Zepbound can increase your risk of experiencing acute and chronic pancreatitis

• Kidney problems, since both alcohol and certain Zepbound side effects (like nausea, diarrhea, and vomiting) can cause dehydration which can lead to acute kidney injury

• Sleep apnea, since alcohol worsens snoring and increases the amount of times you either stop breathing or experience shallow breathing during the night

If you take other medications that shouldn’t be mixed with alcohol — such as antidepressants, benzodiazepines, opioids, and certain sleep medications — you may also be at increased risk of experiencing serious side effects if you drink on Zepbound. 

If none of the above applies to you, but you’re generally more sensitive to alcohol, or if you experience Zepbound side effects fairly regularly, it may not be the best idea for you to mix alcohol and Zepbound.

To understand your specific risk of drinking while taking Zepbound, talk to your healthcare provider.

Drinking alcohol while taking Zepbound can increase the likelihood of experiencing side effects such as nausea or low blood sugar. Zepbound has a half-life of 5 days, so it may take about 30 days for it to fully leave your system, though side effects often improve sooner.Your healthcare provider is the best person to advise you on when it’s safe to drink alcohol after you stop taking Zepbound. 

Drinking alcohol on Zepbound is riskier for some people than others. If you’re in generally good health and don’t have any other conditions that increase your risk (and, ideally, your healthcare provider has given you the OK), it’s probably OK to enjoy an occasional drink on Zepbound. Here’s how to do so safely:

• Don’t overdo it. The recommended daily limit is one drink for women and up to two drinks for men, but even that may feel like too much on Zepbound. 

• Stay hydrated. Alcohol is dehydrating, and if you’re experiencing certain Zepbound side effects like nausea or diarrhea, those can be dehydrating, too. Get ahead of dehydration by drinking plenty of water throughout the day, and especially when you’re drinking.

• Don’t drink on an empty stomach. Drinking on an empty stomach can worsen the effects of alcohol and make you feel the effects of alcohol even more. 

• Avoid cocktails with extra ingredients, especially added sugar. Extra ingredients can pack in extra calories, which can further slow your weight loss efforts on Zepbound. Plus, added sugar can worsen Zepbound side effects like diarrhea.

• Pay attention to how it makes you feel. If you start feeling woozy or sick when you drink on Zepbound, your body is sending you a message. It may make sense to pull back on the alcohol and enjoy a mocktail (or glass of water) instead.

Yes, Zepbound can help reduce alcohol cravings. We can see this in the research as well as reviews of Zepbound, where people often share how they’ve lost their taste for alcohol since starting the medication. An analysis of over 68,200 social media posts found that after starting Zepbound or semaglutide, the active ingredient in Ozempic and Wegovy, people self-reported:

• A reduction in their cravings for alcohol

• Decreased desire to drink

• Drinking fewer drinks when they did drink

• A reduction in binge drinking

Researchers believe this may be due to the way GLP-1 medications affect dopamine signaling in the brain, which could reduce the rewarding effects of alcohol. Essentially, by reducing the dopamine “hit” typically associated with drinking, Zepbound may make drinking feel less rewarding. While research is still in its early days, several studies have begun to explore the potential of GLP-1 drugs to possibly treat alcoholism and other substance use disorders.

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While drinking alcohol on Zepbound isn’t strictly off-limits, that doesn’t necessarily mean it’s the greatest idea. Even if there’s no direct drug interaction, alcohol can affect how you feel on the medication and make it harder to reach your treatment goals. Here’s what to remember:

• Regular drinking may slow weight loss. Alcohol lowers your inhibitions, increases appetite, and makes high-calorie foods more tempting, all of which can undermine your progress on Zepbound.

• Drinking alcohol can worsen Zepbound’s side effects. Alcohol can exacerbate Zepbound’s gastrointestinal side effects and increase the risk of dehydration, kidney issues, and pancreatitis.

• Sleep quality can take a hit. Alcohol disrupts restful sleep and raises cortisol levels, both of which can contribute to weight gain.

Let your body — and your healthcare provider — be your guide when it comes to alcohol and Zepbound. If you have underlying health conditions or take certain medications, drinking on Zepbound could be dangerous. Even if you’re otherwise healthy, but you notice drinking makes you feel worse, it may not be worth it.